Provider Demographics
NPI:1568579555
Name:DOLESHAL, BARBARA (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:DOLESHAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3701
Mailing Address - Country:US
Mailing Address - Phone:252-335-4140
Mailing Address - Fax:
Practice Address - Street 1:305 E MAIN ST
Practice Address - Street 2:ALBEMARLE MENTAL HEALTH CENTER
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-4425
Practice Address - Country:US
Practice Address - Phone:252-331-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH98882084P0800X
NC2006-016502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117539003Medicaid